Background: Chronic kidney disease (CKD) is one of the significant public health problems that is characterized by structural and functional changes due to various causes. Periodontal disease has risen as a nontraditional risk factor for CKD since it is considered a source of inflammatory products in systemic disease.

Objective: The objective of the study was to investigate the association between serum and salivary levels of neutrophil gelatinase‐associated lipocalin (NGAL) and the periodontal health status of patients with CKD.

Methodology: A cross‐sectional study was carried out to achieve the goal. It involved 150 adult patients with CKD, with and without hemodialysis (HD). Assessment of the periodontal health status was done through the measurement of periodontal parameters. Moreover, samples of saliva and serum were collected from each patient and examined for NGAL levels using an enzyme‐linked immunosorbent test.

Results: The study findings illustrated a significant elevation in the mean concentration of NGAL in saliva in comparison to serum in both groups (saliva 540.554 ± 100.595 ng/mL, 458.134 ± 99.450 ng/mL) versus serum (274.138 ± 70.18 ng/mL, 351.66 ± 99.451 ng/mL) ( p   < 0.001). As well as significant elevation of the biomarker was also pronounced in the saliva of the CKD group not on HD in comparison with the HD group (540.554 ± 100.595 ng/mL) versus (458.134 ± 99.450 ng/mL), respectively, p ‐value < 0.001. Regarding periodontal health status, findings showed that from the total sample of patients comprising 150 patients, the majority of them had periodontitis (42%) in the non‐HD group and (38.6%) in the HD group (total 80.6%) while the prevalence of gingivitis was (8%) in non‐HD group and (11.3%) in HD group (total 19.3%). In addition, results revealed a significant association of serum and salivary levels of NGAL with patients who have CKD on HD. On the other hand, the association with periodontal parameters was only clarified with the salivary level of NGAL.

Conclusion: Elevated NGAL levels in saliva were significantly associated with CKD patients on HD as well as with clinical periodontal parameters.